Understanding and Implementing Trauma-Informed Care for Clients in Pain

Course #9620L-


Study Points

  1. Define trauma and chronic pain, including their prevalence and impacts
  2. Identify what trauma-informed care is and how we can implement its principles while staying within our scope of practice
  3. Recall expected outcomes from implementing trauma-informed pain care
  4. Identify polyvagal theory and its application in working with clients in pain and trauma

    1 . Which of these is NOT considered one of the four pillars of trauma-informed care?
    A) Validate someone's trauma
    B) Understand the prevalence of trauma
    C) Aim to avoid retraumatization
    D) Acknowledge signs and symptoms of trauma

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    2 . What is a trauma-informed approach to handling a client who is verbalizing a lot of unprocessed trauma?
    A) Inform them that their current issues likely have a root in childhood trauma.
    B) Start asking them more personal questions so they don't feel invalidated.
    C) Inquire whether they have a qualified and appropriate professional to process their experiences with.
    D) Change the subject to avoid any risk of moving outside of your scope of practice.

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    3 . Which is NOT one of the six core principles of trauma-informed care?
    A) Trustworthiness
    B) Peer support
    C) Reliability
    D) Safety

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    4 . What are the six principles of trauma-informed care?
    A) Safety, trustworthiness and transparency, peer support, collaboration and mutuality, empowerment, voice and choice, and cultural issues
    B) Safety, reliability, peer support, autonomy, collaboration and mutuality, integrity
    C) Safety, trustworthiness and transparency, peer support, communication, resiliency, and cultural issues
    D) Safety, trustworthiness and transparency, peer support, connection, integrity, and cultural issues

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    5 . What are the four main types of PTSD symptoms?
    A) Re-experiencing, anxiety, negative alterations in mood and cognition, and hypoarousal
    B) Re-experiencing, avoidance, negative alterations in mood and cognition, and hyperarousal
    C) Re-experiencing, avoidance, negative alterations in mood and cognition, and hypoarousal
    D) Re-experiencing, anxiety, negative alterations in mood and cognition, and hyperarousal

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    6 . How many Americans have experienced at least some type of traumatic event?
    A) 50%
    B) 80%
    C) 75%
    D) 70%

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    7 . People who have experienced trauma are how many times more likely to become an alcoholic, develop a sexually transmitted disease, or inject drugs?
    A) Two
    B) Four
    C) Three
    D) Six

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    8 . The way a person responds to a traumatic event depends on
    A) whether they were active or helpless.
    B) their previous trauma history.
    C) personality.
    D) All of the above

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    9 . Which of the following is a symptom of trauma?
    A) GI disruptions
    B) Feeling out of control
    C) Shame
    D) All of the above

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    10 . Which of the following statements is TRUE about trauma?
    A) We should assume virtually everybody lives with trauma.
    B) We need to process all our trauma to be psychologically healthy.
    C) We typically recover well from traumatic events.
    D) About 10% of Americans have PTSD in any given year.

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    11 . Which of the following statements is TRUE about chronic pain?
    A) Pain sensitivity can be higher in those living with trauma or with a traumatic history.
    B) Pain is only considered chronic if it has persisted longer than four months.
    C) Chronic pain has a cure.
    D) Pain is only considered chronic if it persists all the time.

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    12 . Which of the following is a known risk factor for chronic pain?
    A) Age
    B) Genetics
    C) Stress and PTSD
    D) All of the above

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    13 . Which strategy would be unhelpful when working with someone in chronic pain and a trauma history?
    A) Pacing the session appropriately and asking for consent generously to not overwhelm the client
    B) Assume our client has adequate capacity or resources to complete their at-home therapeutic exercises
    C) Observing for signs of safety in the client during a session, especially when there's an increase in proximity or more sensitive information is being discussed
    D) Empower your client with supportive language and an authentic confidence in their resiliency

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    14 . Which of the following changes might occur in someone with trauma?
    A) Upregulated response to stress
    B) Abnormal fear processing
    C) Hippocampal atrophy
    D) All of the above

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    15 . A parasympathetic "freeze" response might include
    A) an inability to think clearly.
    B) increased heart rate.
    C) dilated eyes.
    D) lightness in the limbs.

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    16 . Having a regulated nervous system means you are
    A) always happy and content.
    B) possess the ability to respond appropriately to stressors.
    C) easily angered.
    D) in a chronic state of calm.

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    17 . Which part of the brain is considered the "smoke detector" region to alert us of potential danger?
    A) Neocortex
    B) Vagus nerve
    C) Limbic system
    D) Brain stem

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    18 . What is true about the vagus nerve?
    A) The vagus nerve increases sympathetic activity.
    B) The vagus nerve connects to brain regions associated with pain processing.
    C) The vagus nerve is the 9th cranial nerve.
    D) The vagus nerve innervates with all internal organs in the abdominal cavity.

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    19 . Which of the following statements about the ventral vagal complex is TRUE?
    A) It is part of the parasympathetic branch.
    B) It is considered the "social engagement system."
    C) A ventral vagal state is a safe, therapeutic state.
    D) All of the above

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    20 . What is an optimal way to respond when a client is in a sympathetic state?
    A) Tell them everything is okay, and they should calm down.
    B) Give them a pillow to punch.
    C) Stay calm, create distance as needed, and observe for new signs of safety and down-regulation.
    D) Tell them they need to start deep breathing.

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    21 . What is an optimal way to respond when a client is in a freeze state?
    A) Tell them they need to look you in the eye and communicate more clearly.
    B) Give them time to respond and simplify your session or communication to avoid further overwhelm.
    C) Ask them to take slow deep breaths.
    D) Tell them to stand up and move around.

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    22 . What is TRUE about a client in a dorsal state?
    A) There will be hypoarousal.
    B) The client may have a flat tone with minimal expressions.
    C) A client may start to dissociate.
    D) All of the above

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    23 . Which of the following statements is TRUE?
    A) Ventral vagal increases sympathetic activation.
    B) Parasympathetic mobilization is our first threat response.
    C) Ventral vagal is considered a survival state.
    D) Ventral vagal is considered a "physiological state of safety."

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    24 . When someone is in a sympathetic state, they might experience
    A) overwhelm.
    B) feeling out of control.
    C) fear.
    D) All of the above

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    25 . What is TRUE about co-regulation?
    A) It is critical to self-regulation.
    B) We can use co-regulation to control how someone feels or responds.
    C) It requires deep breathing exercises.
    D) None of the above

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